Acne is a condition that leads to breakouts of skin lesions, commonly called pimples. Although the exact cause isn’t known, it’s believed to occur from a combination of factors: excess oil production (sebum), clogged pores, bacteria and inflammation. Excess oil, dirt, hair and skin cells accumulate in the follicle and clog the pore. Bacteria on the skin thrive in this mixture, causing inflammation and the development of pimples.

There are several types of acne lesions. Pore blockage close to the surface of the skin causes minor inflammation and the development of a comedo. A closed comedo, or whitehead, is caused by a blocked or narrowed opening into the follicle. An open comedo, or blackhead, looks black or discolored because the surface of the plug is dark. A papule is a solid lesion that causes a small bump on the surface of the skin. It occurs when inflammation is a bit deeper. Even deeper inflammation causes the formation of a pustule, a dome shaped lesion filled with pus. Deep blockage and inflammation leads to the most serious types of acne lesions, nodules and cysts. A nodule is a painful, solid, dome-shaped pimple that extends deep into the skin. A cyst is a deep, painful, pus-filled pimple that is severely inflamed. Both nodules and cysts can lead to significant scarring.

Acne is a very common skin condition that typically appears between 10 and 13. According to the American Academy of Dermatology, nearly 100 percent of teens have at least an occasional acne breakout. For most people, the symptoms last about five to ten years. The most common sites of acne lesions are the face, neck, chest, shoulders, scalp, upper arms and legs.

A New “Wrinkle” in Acne Treatment

The American Academy of Dermatology estimates Americans spend more than one hundred million dollars every year on over-the-counter acne treatments. Roughly 40 percent of teens seek a physician’s care for acne treatment.

Chicago Facial Plastic Surgeon Steven Dayan, M.D., recently looked at a different type of potential treatment for acne, BOTOX®. BOTOX is an injectable drug made from Clostridium botulinum, a bacterium that produces a toxin commonly associated with food poisoning. Small doses of the drug are approved for treatment of wrinkles and a few other medical conditions.

Dayan says he noticed a few years ago that patients who were having BOTOX treatment for forehead wrinkles reported having fewer acne breakouts. So he and his colleagues decided to test the treatment in a small clinical trial. Each participant received a BOTOX injection under or around the acne lesion, on one side of the face. On the other side, researchers gave injections of saline. Dayan says the BOTOX side of the face showed about a 20 percent improvement in acne.

Dayan isn’t sure how BOTOX works for acne. It’s possible the drug reduces inflammation or disrupts the signals that control oil production. The treatment appears to work best for those with mild to moderate acne and the results last for about two to three months. BOTOX also appears to work better for lesions on the chin and forehead and is less effective for acne on the cheeks.

Much more research needs to be done to test the effects of BOTOX in larger groups of acne patients. Thus, Dayan recommends patients follow the advice of their physician or dermatologists for acne skin care. He also cautions that if too much BOTOX is used, or the drug is injected into certain areas, it can cause temporary unwanted cosmetic problems from temporary muscle weakness. Traditionally, BOTOX for wrinkles is injected into the muscle. For acne, the BOTOX is injected just under the skin, around the area of the acne lesion. For information about the study, or to participate, go to: http://www.denovaresearch.com/